Back to Journals » Patient Preference and Adherence » Volume 5
![Highly-accessed](assets/img/article_icons/highly-accessed.png)
Cardiac crossroads: deciding between mechanical or bioprosthetic heart valve replacement
Published 17 February 2011 Volume 2011:5 Pages 91—99
DOI https://doi.org/10.2147/PPA.S16420
Review by Single anonymous peer review
Peer reviewer comments 2
Maggie N Tillquist1, Thomas M Maddox2
1School of Medicine, University of Colorado Denver, Denver, CO, USA; 2VA Eastern Colorado Health Care System, and Department of Medicine (Cardiology), University of Colorado Denver, Denver, CO, USA
Abstract: Nearly 15 million people in the United States suffer from either aortic or mitral valvular disease. For patients with severe and symptomatic valvular heart disease, valve replacement surgery improves morbidity and mortality outcomes. In 2009, 90,000 valve replacement surgeries were performed in the United States. This review evaluates the advantages and disadvantages of mechanical and bioprosthetic prosthetic heart valves as well as the factors for consideration in deciding the appropriate valve type for an individual patient. Although many caveats exist, the general recommendation is for patients younger than 60 to 65 years to receive mechanical valves due to the valve's longer durability and for patients older than 60 to 65 years to receive a bioprosthetic valve to avoid complications with anticoagulants. Situations that warrant special consideration include patient co-morbidities, the need for anticoagulation, and the potential for pregnancy. Once these characteristics have been considered, patients' values, anxieties, and expectations for their lifestyle and quality of life should be incorporated into final valve selection. Decision aids can be useful in integrating preferences in the valve decision. Finally, future directions in valve technology, anticoagulation, and medical decision-making are discussed.
Keywords: prosthetic heart valves, patient preference, valve type, anticoagulant, structural valve deterioration
© 2011 The Author(s). This work is published and licensed by Dove Medical Press Limited. The
full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution
- Non Commercial (unported, v3.0) License.
By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted
without any further permission from Dove Medical Press Limited, provided the work is properly
attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.